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PrediXcan is a gene-based association method that estimates the expression of individuals\u2019 genes and examines their correlation to specified phenotypes. To interrogate the utility of using PrediXcan as a tool for detecting associations between genetic factors and azathioprine side effects, we aimed to determine whether the genetically predicted expression of\n                      <jats:italic>TPMT<\/jats:italic>\n                      or\n                      <jats:italic>NUDT15<\/jats:italic>\n                      was associated with leukopenia or other known side effects of azathioprine.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a retrospective cohort study of 1,364 new users of azathioprine (patients taking azathioprine with an organ transplant indication were excluded) with electronic health record (EHR)-reported White race. We used PrediXcan to impute expression in liver tissue, tested its association with pre-specified phecodes representing known side effects (e.g. skin cancer), and completed chart review to confirm cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among confirmed cases, patients in the lowest tertile of\n                      <jats:italic>TPMT<\/jats:italic>\n                      predicted expression had significantly higher odds of developing leukopenia (OR\u2009=\u20093.30, 95%CI: 1.07\u201310.20,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04) versus those in the highest tertile; no other side effects were significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The results suggest that this methodology could be deployed on a larger scale to uncover associations between genetic factors and drug side effects for more personalized care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s40360-026-01093-4","type":"journal-article","created":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T04:48:57Z","timestamp":1770439737000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association between genetically predicted expression of TPMT and azathioprine adverse events"],"prefix":"10.1186","volume":"27","author":[{"given":"Alyssa","family":"Steitz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura L.","family":"Daniel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Puran","family":"Nepal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alyson L.","family":"Dickson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacy","family":"Zanussi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tyne W.","family":"Miller-Fleming","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter S.","family":"Straub","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei-Qi","family":"Wei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ge","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Maizel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy J.","family":"Cox","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana M.","family":"Hung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"QiPing","family":"Feng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. 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